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Tricuspid Valve Endocarditis

By H. Tbomasmilhorn and Ph. D


Tricuspid valve endocarditis is a disease primarily found in intravenous drug abusers. It occurs much less often than left-sided endocarditis and has a better prognosis. The triad of intravenous drug abuse, Staphylococcus aureus septicemia, and pul-monary embolism with or without a tricuspid regurgitation murmur can be pathognomonic for tricuspid valve endocarditis. Pulmonary signs and symptoms predominate. Case Report A 32-year-old woman came to the emergency department of a major hospital complaining of a cough productive of yellow sputum and fever, chills, backache, and increasing dyspnea for about 1 week. She stated that her appetite had been poor and that she had lost 20 pounds over the previ-ous 4 weeks. She gave a history of intravenous cocaine use. On admission her temperature was 39.4DC (103DF), her respiratory rate was 22/min, and her blood pressure was 98/60 mmHg. She had a grade 216 systolic murmur without radiation heard best along the left sternal border. She had no knowl-edge of a previous murmur. Pulmonary examina-tion found a few scattered wheezes in the left lower base with moderately decreased breath sounds over the right lower lung field. Percussion was bilaterally equal, and vocal fremitus was nor-mal. Needle tracts were numerous on both arms. Roth spots, Osler nodes, splinter hemorrhages, and Janeway lesions were not present. The re-mainder of her physical examination was normal. Admission laboratory work showed her white cell count was 16 X 1061L (16,OOO/mm3); hemo-globin, 57 gIL (5.7 gldL); and hematocrit, 0.18. A urine analysis was normal. A chest radiograph showed diffuse bilateral parenchymal densities suggestive of cavitating pneumonia

Year: 2016
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